The Centers for Medicare & Medicaid Services (CMS) released the updated calendar year 2021 fee schedule on Jan. 5. This update was expected after Congress passed legislation in December to reduce scheduled payment cuts.
As a result of the Consolidated Appropriations Act of 2021:
- CMS incorporated a 3.75% positive adjustment into the 2021 physician payments. CMS had planned cuts of 6% to 10% for ophthalmology in the final 2021 Physician Fee Schedule released in December. Due to the 3.75% adjustment, ophthalmologists’ reimbursements will largely be improved and some practices may even see increases. The effect will vary by practice and provider.
- Payment for the add-on complexity code (G2211), which was significantly negatively impacting the conversion factor, was delayed for three years. The Academy will continue to fight for fair reimbursements for ophthalmologists.
- The original 2021 conversion factor was set to be a reduction over 10% from the 2020 rate. However, due to Academy efforts along with the Surgical Care Coalition and physicians across the country, CMS announced this week that the 2021 conversion factor would be $34.89, a 3.3% reduction from the 2020 rate.